The Impact of PPACA - Changing Times

A UBA Partner FirmThere is still a divided public: “The public remains deeply divided. As of last month, more Americans viewed the law unfavorably (46%) than favorably (37%)—a shift from four years earlier, when respondents favored it 42% to 40%, according to a Kaiser Family Foundation poll … ’The fundamental impetus for the law was to lower the number of uninsured, and it has clearly done that,’ said Larry Levitt, a senior vice president at the Kaiser Family Foundation. ’But simply getting people insured doesn’t mean health care is affordable.’” 1

There is the Patient Protection and Affordable Care Act (PPACA) dismantling drive in Washington, D.C.: “(Bloomberg) – Republicans, newly in charge of the House and Senate, begin their campaign to dismantle PPACA with a vote this week to ease the law’s requirement thatlarge employersgive health insurance to full-time workers.” 2

It appears that according to the Kaiser Family Foundation, the public doesn’t think too highly of health care reform. Or, at least doesn’t feel that they fully understand the law and how it will really impact them. It also appears that Washington, D.C. continues its drive for “change;” albeit a different form of “change” than just a few years ago. When I look at the law, the rules & regulations, and the guidance for health care reform, I can sympathize with both the public and the lawmakers. As a trusted advisor at The LBL Group (a UBA Partner Firm), my clients rely on the information, knowledge and guidance that I provide to make the best business decisions for them. All this said, it is important to remember that everything comes at some cost. In California, a state that has embraced health care reform, the unprecedented fourth-term governor even commented that, “Providing the security of health coverage to so many Californians who need it is the right thing to do. But it isn’t free. Although the federal government will temporarily foot much of the bill, new state costs – now and more so in the future – will run into the billions.” (http://jrreport.wpengine.com/2015/01/06/brown-on-health-coverage-right-thing-to-do-but-it-isnt-free/) And that is just for California. It is also worth noting that businesses with fewer than 50 employees that provided health insurance under AB1672 (California Small Group Insurance Law in place since 1993, now AB1083) are required to offer this coverage to all full-time employees working at least 30 hours per week, and similar rules exist in some other states.

Where will all these things take us in the coming years?

Kaiser Permanente has been viewed as an example of how things could look in the future, but there are others that are making a discernable impact on health care management, delivery and cost. For Example, Anthem Blue Cross along with MemorialCare Health System, Cedars-Sinai, Good Samaritan Hospital, Huntington Memorial Hospital, PIH Health, Torrance Memorial Medical Center and UCLA Healthannounced Vivity. This is the first national partnership between an insurer and competing health systems, and it includes enhanced alignment in health delivery as well as a full risk/gain share among all the partners. Additionally, according to Anthem Blue Cross West Region President Pam Kehaly, premiums will be “lower than what exists on the market today.” If we work our way to the middle of the country, a bright spot will be found at The Surgery Center of Oklahoma (http://www.surgerycenterok.com/). Here, all surgeries performed are at one low price, without any hidden fees. They use a simple, three-step process to make it easy.

On the other side of the country is another prominent health system making a stand on health care delivery and the cost of insurance. North Shore LIJ formed a new health plan called CareConnect (http://www.nslijcareconnect.com/) with the motto “Changing what to expect from health insurance.” To validate their motto, in their second year of operations they have been able to reduce the premium paid by their employer groups.

These are just three examples from across the country. There are many more and even more in the works for sure. Health care and health insurance are in changing times, and nobody knows what the future holds. In the meantime, if you are a U.S. citizen or legal resident who is required to maintain health insurance, work to be informed. If you are an employer, or other purchaser of group health benefits, make sure that you are working with a trusted advisor like the Partners of United Benefit Advisors. Lastly, check to see if your advisor or advisory firm works with a National Association of Health Underwriters (NAHU)-certified PPACA expert.